Background

- Treatment of two postoperative endophthalmitis cases due to Aspergillus flavus and Scopulariopsis spp. with local and systemic antifungal therapy

Endophthalmitis is an intraocular infection caused by bacteria or fungi. Eventhough it is a rare condition, therapeutic options are limited and it affects the vision seriously. The incidence of endophthalmitis after cataract surgery varies between 0.072%–0.13% as reported in publications of the past 10 years [1]. In 83% of postoperative endophthalmitis cases, the infectious agents are bacteria, especially gram positive bacteria. However, few studies have been based on collected microbiology data regarding fungi. In these series the rate of fungal endophthalmitis varies between 8.6–18.6% [2,3]. This aspect is also lacking in another large prospective series[4]. Candida albicans and Aspergillus spp. are the most frequently isolated organisms in fungal cases [2,5]. Treatment of endophthalmitis with fungal etiology is difficult. Systemically or intra-vitreally administered amphotericin-B is the most commonly used drug in the treatment of fungal endophthalmitis. It has been reported that it can also be given in the anterior chamber [6]. In recent years, new anti-fungal agents such as caspofungin and voriconazole have been developed as an alternative to amphotericin-B, and successful results were reported [7-10].

The present article discusses the outcomes of two cases of endophthalmitis due to A. flavus and Scopulariopsis spp. following phacoemulsification and intraocular lens (IOL) implantation.